Computerized Dynamic Posturography-Guided Vestibular Rehabilitation Improves Vestibular Sensory Ratios

Background: Vestibular deficits are common and debilitating, and many patients struggle with dynamic balance, even after treatment with standard rehabilitation techniques. Objective: The objective of this study was to measure changes in computerized dynamic posturography sensory ratio information after computerized vestibular retraining therapy (CVRT). Methods: This prospective, single-group, interventional study enrolled adult participants with stable, unilateral vestibular deficits. Sensory ratios were obtained from sensory organization test scores before and after 12 twice-weekly sessions of CVRT. Results: Prior to CVRT, sensory organization test ratios indicated significant difficulty maintaining equilibrium on the moving, sway-referenced platform. After CVRT, the visual ratio (VIS) increased by 0.12 (-0.09 to 0.30; P = .0498), the vestibular ration (VEST) increased by 0.10 (-0.060 to 0.25; P = .0122), and the dynamic stability ration (DSR) increased by 0.15 (0.03 to 0.24; P = .0012). The somatosensory and visual preference ratios changed negligibly. Participants with mild disability [Dizziness Handicap Inventory (DHI) ≤30] showed no change while participants with moderate-to-severe disability (DHI >30) had significant improvements in VIS, VEST, and DSR. Conclusions: CVRT was associated with changes in VIS and VEST sensory ratios and improved postural control under conditions that favor use of vestibular information, consistent with increased weighting of vestibular information over vision (Clinicaltrials.gov registration NCT04875013; April 27, 2021).